| Revision ACL Surgery | | | | - Synthetics... |
| After you have an ACL reconstruction you lead a | | | | Steps in Planning ACL Revision |
| normal injury free return to all activities. It is an | | | | - Determine the cause of Failure |
| unfortunate fact that sometimes even after you | | | | - Choose the appropriate graft |
| have your ACL reconstructed, that you can do | | | | - Autograft |
| something to re-injure the ligament and require | | | | - Quadriceps tendon |
| another reconstructive surgery. | | | | - Patellar tendon – same or opposite side |
| Many times if you re-injure your ACL, another | | | | - Semi-t opposite side |
| reconstruction is needed. If this is the case, well over | | | | Allograft |
| 50% of the time the reconstruction requires two | | | | - Patellar tendon |
| surgeries. The first surgery requires doctor to | | | | - Achilles tendonsynthetic |
| remove the old screws from the tunnels (figure 1), | | | | Plan the hardware removal |
| repair any damage that occurred to the other | | | | Plan tunnel placement |
| structures of the knee and to use donor bone plugs | | | | Large tunnel.... |
| (figure 3) to graft into the tunnels (figure 2). After a | | | | Revision anterior cruciate ligament (ACL) |
| sufficient period of time to allow for proper healing of | | | | reconstruction is indicated for selected patients with |
| the bone grafting, Doctor will then perform the | | | | recurrent instability after a failed primary procedure. |
| second phase of the reconstruction. This surgery | | | | The cause of the failure must be carefully identified |
| consists of drilling new tunnels and then | | | | to avoid pitfalls that may cause the revision to fail as |
| reconstructing the ACL again.... | | | | well. Associated instability patterns must be |
| Causes of Failure of ACL Reconstruction | | | | recognized and corrected to achieve a successful |
| - Incorrect Technique | | | | result. The choice of graft, the problem of retained |
| - Incorrect tunnel Placement | | | | hardware, and tunnel placement are the major |
| - Graft fixed in lax position | | | | challenges of revision ACL reconstruction. |